George Monbiot (The shadow government: it's how politicians get their way, 13 March) puts his finger on the corrosive effect of ministerial preferment for those singing the "right" tune (from hymn sheets increasingly written by secondees from, or aspirants to, the big consultancies and corporations). Organisations like the King's Fund, the NHS Confederation and the Royal Colleges left it far to late to voice their serious concerns. Rigid control down the NHS chain of command ensured compliance there and, despite his coded dismay, David Nicholson's rush to assemble the GP commissioning groups and hollow out the primary care trusts now leaves the coalition with the fallback that it is now too late to stop.

Your front-page story (NHS costs soar as GPs focus on health reforms, 13 March) describes one facet of what will prove to be the soaring cost of GP commissioning. With GPs better paid than most of the professional managers they will displace, will their "responsibility enhancements" give value for money?

Lansley clearly can't be entrusted with salvaging the mess and will go down as one of the worst health secretaries yet – not that far below Alan Milburn, whose legacy is now a millstone round Andy Burnham's neck. Nick Clegg certainly finds himself on the wrong side of destiny, along with his grandfather, who as editor of the British Medical Journal in the late 1940s helped voice the BMA's fierce opposition to the original creation of the NHS, later acknowledging his error. Perhaps Nick will too, though he will have more to regret.Colin GodberWinchester, Hampshire

• How can general practitioners possibly commission the existing 54 medical specialities? It is the medical specialists in secondary care who have the knowledge, skills and dedication necessary to plan the future of their services. However, their contribution is wasted because of the market dogma which determines that there should be an arm's-length relationship between the buyers and sellers of health services. Without this dogma, GPs, hospital consultants and others would collaboratively determine the future of particular services. But then there would be no need for the commissioning frenzy which constitutes the health and social care bill currently before parliament, nor would the large City firms and private healthcare companies carve out their huge profits from the NHS budget. Morris BernadtLondon

• George Monbiot and Polly Toynbee provide damning evidence of the dark heart of this Con-Dem government. The wholesale privatisation of our fast-diminishing public provision is the ideological driver of all aspects of current government policy. As capital failed to find sufficient profit from domestic manufacturing in the 70s/80s due to the rise of competition in the far east, with its cheap labour base, it turned to the manipulation of the financial markets. Manufacturing financial products became more profitable than manufacturing anything that may have had some social usefulness. This was enormously successful for almost two decades, until its own excesses brought about the current crisis.

Where now for capital? The obvious place is all those functions that have been, rightly, the province of government, since they require some degree of democratic control and accountability. We now have a government committed to handing over to private corporations the final areas of social provision so that capital can replenish its diminished returns. Hence, as Monbiot shows, the corporate sector taking over the committees overseeing the privatisation process. Ironically, Shirley Williams' memorial is likely to be that of destroyer-in-chief of the most successful and socially useful area of public provision Britain has achieved, the National Health Service – no longer national and no longer a service.Tim TowersChidham, West Sussex

• Let's get real here. The only thing that's going to make a difference to the NHS bill is votes – votes of Lib Dem peers and MPs. Nothing that happens after the bill is passed is other than wishful thinking. The corporations who have lobbied for the bill for over 20 years will have got their prize.

I am starting to collect quotes from government spokesmen which promise us free healthcare in the future. I've saved a thick file of articles over the past year, so should be able to unearth quite a number. Then if I am told in future that a treatment I need is no longer available on the NHS, I will quote a relevant promise. It won't be much, but it's all I have.Jeanne WarrenGarsington, Oxfordshire

• Polly Toynbee, responding to Shirley Williams' criticism of her remarks about the health bill, concludes with the statement: "If anyone doubts the scale of change, a second NHS hospital this week put itself up for takeover or private sale, after Hinchingbrooke was called a 'one-off'."

I would remind Polly that the process for selecting Circle to operate Hinchingbrooke hospital started under the last Labour government, and the decision to transfer the management was made using powers set up by Labour in 2001. It is telling that Polly Toynbee should conclude her response to Shirley Williams' criticisms with a statement that is not exactly a lie, but so economical with the facts that it bears an even scantier relation to the truth.Kilian BourkeCambridgeshire Liberal Democrats

• Another Liberal Democrat conference, another crowd of passionate and articulate demonstrators defending their ideal of the NHS. Being Liberals, many of us of course listened to them and argued with them.

I learned that those I listened to are opposed not only to the current bill but also to almost all of the other changes brought in by the Labour government between 1997 and 2010. I also learned that they resist the idea that there need to be any restraints on NHS spending. They want the complete Polly Toynbee: a steady increase in health spending each year above and beyond whatever may be the rate of growth, paid for by continuing increases in taxation.

I don't remember the NHS of 15-20 years ago as beyond criticism. Changes in medical technology, in drugs, in methods of treatment and in life expectancy have in any event made it impossible to go back to that, let alone to the NHS of 1948, designed for a very different society coming out of a world war. If we want to maintain the NHS – as we all do – it is necessary to adjust.William WallaceLiberal Democrat, House of Lords

• I would suggest that if Tim Farron and the Liberal Democrats are feeling guilty We must stop apologising, 9 March), it's because they know what they are doing is wrong. I voted for the Liberal Democrats because I thought they could be trusted to have the courage of their convictions. It now appears that my judgement was misplaced. Having achieved some power, they may "retain a conscience" but they do not have the moral fibre to stand up and be counted, they appear no more trustworthy than any other party. Claire HuntYeovil, Somerset

• There's so much to chuckle at in Tim Farron's entertainingly daft piece. However, I have to take serious issue with his claim that had the Lib Dems not joined the coalition, the current health and social care bill would have passed into law unamended last year. In fact, that's very unlikely, as the Conservatives didn't have a parliamentary majority. Isn't that exactly why we've got the coalition?Paul WorthingtonCaerleon, Gwent

• By splitting the Labour party, Shirley Williams kept the party out off government for almost 20 years. As a result of her support for the destruction of the NHS she is almost certainly ensuring the Liberal Democrats will not get back into government for another 50 years. Wouldn't it be wonderful if she could be persuaded to join the Tories!Martin QuinnTavistock, Devon